Wright Melissa A, Shapiro Danielle S, Chopra Aman, Murthi Anand M
Department of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Department of Orthopedic Surgery, Georgetown University School of Medicine, Washington, DC, USA.
Shoulder Elbow. 2025 Jan;17(1):36-42. doi: 10.1177/17585732231197171. Epub 2023 Aug 30.
The aim of this study was to evaluate health literacy in orthopedic shoulder and elbow patients.
This retrospective cross-sectional study included all new English-speaking adult patients presenting to two fellowship-trained shoulder and elbow surgeons from October 2020-July 2021. Patients who did not complete the Brief Health Literacy Screen Tool (BRIEF) were excluded, leaving 594 patients. Patient demographics and patient-reported outcome scores were also collected.
Average BRIEF score was 18.7 (range, 4-20), with limited health literacy (BRIEF <17) in 84 patients (14.1%). Patients with limited health literacy were significantly older (58 ± 18 vs. 54 ± 15 years, p = 0.03), less likely to be employed (34 [40%] vs. 332 [65%], p < 0.001), and less likely to have private insurance (35 [42%] vs. 330 [65%], p < 0.001). Average area deprivation index percentile was significantly higher (more deprivation) with limited (38 ± 20) compared to adequate health literacy (32 ± 21; p = 0.027). PROMIS physical (40.5 ± 8.5 vs. 45.5 ± 7.6, p = 0.001) and mental health scores (46.9 ± 10.5 vs. 51.0 ± 8.6, p = 0.015) and pain visual analog scale scores (5.3 ± 2.9 vs. 4.6 ± 2.7, p = 0.017) were significantly worse with limited health literacy.
Limited health literacy is present in shoulder and elbow patients and may affect patient-reported outcomes. Surgeons must recognize this in order to provide high-level equitable care.
Level III, retrospective cohort.
本研究旨在评估肩部和肘部骨科患者的健康素养。
这项回顾性横断面研究纳入了2020年10月至2021年7月期间所有新就诊的、说英语的成年患者，这些患者均由两位接受过专科培训的肩部和肘部外科医生诊治。未完成简易健康素养筛查工具（BRIEF）的患者被排除，最终纳入594例患者。同时收集了患者的人口统计学数据和患者报告的结局评分。
BRIEF平均得分为18.7（范围4 - 20），84例患者（14.1%）健康素养有限（BRIEF < 17）。健康素养有限的患者年龄显著更大（58 ± 18岁 vs. 54 ± 15岁，p = 0.03），就业可能性更低（34例[40%] vs. 332例[65%]，p < 0.001），拥有私人保险的可能性也更低（35例[42%] vs. 330例[65%]，p < 0.001）。与健康素养充足的患者相比，健康素养有限的患者平均区域贫困指数百分位数显著更高（贫困程度更高）（38 ± 20 vs. 32 ± 21；p = 0.027）。健康素养有限的患者在PROMIS身体（40.5 ± 8.5 vs. 45.5 ± 7.6，p = 0.001）、心理健康评分（46.9 ± 10.5 vs. 51.0 ± 8.6，p = 0.015）以及疼痛视觉模拟量表评分（5.3 ± 2.9 vs. 4.6 ± 2.7，p = 0.017）方面均显著更差。
肩部和肘部患者存在健康素养有限的情况，这可能会影响患者报告的结局。外科医生必须认识到这一点，以便提供高水平的公平医疗服务。
三级，回顾性队列研究。
